Community Health Worker

Recognized Skill Standards
September 13, 2019


The Community Health Worker competency-based occupational framework was submitted for skill standards recognition by Healthcare Career Advancement Program (H-CAP), which participated in the frameworks’ development. H-CAP is a national labor/management organization that promotes innovation and quality in healthcare career education. Its board includes Service Employees International Union locals and healthcare employers across all sectors of healthcare. H-CAP’s mission is to transform healthcare workforce development and education to support and engage a well-trained and valued workforce to better meet the need for quality care in a rapidly changing industry. 


The development of the occupational framework was updated in December 2017, facilitated by the Urban Institute under a grant from the U.S. Department of Labor (DOL). The grant funded an initiative to identify the content (industry competencies) and worker qualifications required to perform in various occupations. The Community Health Worker framework meets the definition and recognition criteria for Texas skill standards. The DOL grant required a rigorous development and validation process that adhered to standard job analysis methodology, including convening industry subject matter experts to identify the work-oriented information and validation by a wider range of practitioners in the occupation. 

The Community Health Worker framework is composed of the following 10 job functions: 1) provides cultural mediation among individuals, communities, and social service systems; 2) provides culturally appropriate health education and information; 3) coordinates care, provides case management support, and assists individuals and communities in navigating health and social service systems; 4) provides coaching and social support; 5) advocates for individuals and communities; 6) helps build individual and community capacity; 7) provides direct health and social service assistance; 8) implements individual and community assessments; 9) conducts outreach to individuals, communities, service providers and groups; and 10) participates in evaluation and research.

Comparing Competency-Based Occupational Frameworks to Texas Skill Standards

The competency-based occupational frameworks have a different format and nomenclature than skill standards recognized in Texas. But the content is the same, and the elements that constitute the frameworks are equivalent to the elements that constitute skill standards. Skill standards elements are composed of work-oriented information, describing the critical work functions, the key activities that make up those functions, and the performance criteria or proficiency level to which the activities must be performed. The occupational frameworks are also composed of these work-oriented elements, called job functions, competencies, and performance criteria, respectively. 

Skill standards are also composed of worker-oriented information, which specifies the skills and knowledge required of the worker to perform the work. The worker-oriented elements include: 

  • Academic knowledge and skills – the level, indicated by a numerical rating, of reading, writing, math, and science required to perform each critical work function.
  • Employability knowledge and skills – the level (numerical rating) of “soft” or transferable skills, common to all occupations, required to perform each critical work function. 
  • Occupational skills, knowledge and conditions – the technical skills and knowledge that are occupation-specific, and the tools, resources, and equipment, required to perform each key activity.

The occupational frameworks are composed of the same worker-oriented elements. The frameworks’ cross-cutting competencies are the equivalent of both the academic and the employability knowledge and skills. The level of each competency is also rated. However, the rating applies to the level of each competency required to perform all the functions across the occupation rather than each work function, as in skill standards. Definitions of the cross-cutting competencies can be found on DOL’s Competency Model Clearinghouse website. The scoring system used to evaluate the level of competency required in each cross cutting skill can be found on the Lumina Foundation’s Connecting Credentials Framework website. For these website links, see the Cross-Cutting Competencies section of each occupational framework. 

In the occupational framework, the equivalent to the standards’ occupational knowledge and skills is called related technical instruction. That element includes occupation-specific knowledge and skills, and the tools and technologies required to perform each job function rather than each key activity, as with skill standards. 

For a side-by-side comparison of the equivalent elements, see the Skill Standards to Occupational Equivalencies link on the Texas skill standards repository web page.

Importance to Texas

Community health workers are frontline public health workers who are bridges between the community and the healthcare, government, and social service systems. They are liaisons, links, or intermediaries between health and social services and the community to facilitate access to services and improve the quality and cultural competence of service delivery. Community health workers also build individual and community capacity by increasing health knowledge and self-sufficiency through outreach, community education, informal counseling, social support, and advocacy. They work in government, non-profit, or private organizations including hospitals, government, ambulatory care facilities, non-profit organizations (religious, grantmaking, civic, professional, or similar organizations), and at community events or may provide individualized support or family services. 

According to Texas Workforce Commission data, community health workers are projected to grow 20 percent by the year 2026, and employ 4,681 Texas workers. The median annual wage in 2017, the latest data available, was $53,157.


On September 13, 2019, the Community Health Worker competency-based occupational framework was recognized as skill standards in accordance with the Guidelines for the Development, Recognition and Usage of Skill Standards.